Effects of total pancreatectomy on the secretion of gut glucagon in humans.

To determine how total pancreatectomy influences the secretion of gut glucagon in man, 15 totally pancreatectomized patients (Px), 14 distally gastrectomized patients (Gx), and 15 healthy subjects were investigated by intravenous arginine infusion test and oral glucose tolerance test. Blood glucose, plasma insulin (IRI), and C-peptide (CPR) levels were determined. Plasma immunoreactive glucagon (IRG) and total glucagon-like immunoreactivity (total GLI) were also measured. Gut glucagon-like immunoreactivity (gut GLI) was calculated to be the difference between total GLI and IRG. In the Px group, arginine infusion did not significantly alter the levels of IRI, CPR, IRG, and gut GLI. Mean basal value of gut GLI in the Px group of 356 +/- 40 pg/ml was significantly higher than 179 +/- 26 pg/ml of the healthy (p less than 0.01) and 182 +/- 24 pg/ml of Gx group (p less than 0.01). Oral glucose loading led to the highest increase of gut GLI in the Px group (p less than 0.01). Thus, extrapancreatic IRG may not be secreted into the plasma in totally pancreatectomized humans in response to arginine stimulation. Complete absence of the pancreas and the deficiency of insulin-effect may lead to a hypersecretion of gut GLI, both in the basal state and after oral glucose loading.